| NPI | 1740689421 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 31439) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 63782) |
| Enumeration Date | 2014-08-18 |
| Last Update Date | 2016-11-07 |